Treatment Discontinuation Patterns for Patients With Chronic Lymphocytic Leukemia in Real-World Settings: Results From a Multi-Center International Study

Introduction: This study assessed treatment discontinuation patterns and reasons among chronic lymphocytic leukemia (CLL) patients initiating first-line (1L) and second-line (2L) treatments in real-world settings. Materials and / Methods: Using deidentified electronic medical records from the CLL Collaborative Study of Real-World Evidence, premature treatment discontinuation was assessed among FCR, BR, BTKi-based, and BCL-2-based regimen cohorts. / Results: Of 1364 1L patients (initiated in 1997-2021), 190/13.9% received FCR (23.7% discontinued prematurely); 255/18.7% received BR (34.5% discontinued prematurely); 473/34.7% received BTKi-based regimens, of whom 28.1% discontinued prematurely; and 43/3.2% received venetoclax-based regimens, of whom 16.3% discontinued prematurely (venetoclax monotherapy: 7/0.5%, of whom 42.9% discontinued; VG/VR: 36/2.6%, of whom 11.1% discontinued). The most common reasons for treatment discontinuation were adverse events (FCR: 25/13.2%; BR: 36/14.1%; BTKi-based regimens: 75/15.9%) and disease progression (venetoclax-based: 3/7.0%). Of 626 2L patients, 20/3.2% received FCR (50.0% discontinued); 62/9.9% received BR (35.5% discontinued); 303/48.4% received BTKi-based regimens, of whom 38.0% discontinued; and 73/11.7% received venetoclax-based regimens, of whom 30.1% discontinued (venetoclax monotherapy: 27/4.3%, of whom 29.6% discontinued; VG/VR: 43/6.9%, of whom 27.9% discontinued). The most common reasons for treatment discontinuation were adverse events (FCR: 6/30.0%; BR: 11/17.7%; BTKi-based regimens: 60/19.8%; venetoclax-based: 6/8.2%). / Conclusion: The findings of this study highlight the continued need for tolerable therapies in CLL, with finite therapy offering a better tolerated option for patients who are newly diagnosed or relapsed/refractory to prior treatments

Community pharmacists’ perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis

Background: Community pharmacists play an intermediary role between prescribing physicians and patients in the United Arab Emirates (UAE) and thus are responsible for ensuring that patients receive optimal cardiovascular disease (CVD) pharmaceutical care.Methods: we used a cross-sectional design to assess the perceptions and practices of community pharmacists concerning pharmaceutical care for patients with CVD. A trained researcher visited randomly selected community pharmacies and used a structured questionnaire to conduct in-person interviews with pharmacists. The questionnaire collected demographic data and information on perceptions and practices regarding CVD pharmaceutical care.Results: Five hundred and fifty-one participants were recruited. The average participant age (mean ± SD) was 35 ± 2.7 years. The average perception score regarding CVD prevention and management was 75.6% (95% confidence interval [CI] 77.1%–74.2%), and the average practice score for CVD prevention and management was 87.1% (95% CI 76.5%–79.6%). Bivariate analysis revealed that gender (p = 0.001), education level (p < 0.001), pharmacy position (p = 0.004), work experience (p < 0.001), number of patients served per day (p < 0.001) and being trained on CVD prevention and management (p < 0.001) were significantly associated with perceptions about the prevention and management of CVD. Better practice scores were seen among older participants (OR 1.01; 95% CI 1–1.019), postgraduates (OR 1.77; 95% CI 1.66–1.89), workers at chain pharmacies (OR 1.24; 95% CI 1.11–1.39), pharmacists in charge (OR 1.22; 95% CI 1.01–1.47), pharmacists with >10 years of experience (OR 11.3; 95% CI 6.01–15.62), pharmacists with 6–10 years of experience (OR 4.42; 95% CI 3.90–5) and pharmacists trained on CVD prevention and management (OR 1.29; 95% CI 1.15–1.46).Conclusion: Pharmacy practitioners working in community pharmacies in the UAE actively engage in delivering pharmaceutical care to patients, playing a role in CVD management and prevention. However, they showed low levels of involvement in other healthcare services, specifically in screening and measuring patients’ weight, glucose levels, and blood pressure, monitoring treatment responses, maintaining medical records, and reviewing medication refill histories. Activities such as educating patients, providing medication counseling, offering support for treatment adherence, and fostering collaborative relationships with other healthcare providers should be encouraged among UAE community pharmacists to ensure the provision of high-quality patient care

Influence of growth stresses and material properties on distortion of sawn timber - numerical investigation

• The board distortion that occurs during the sawing and the drying process causes major problems in the utilisation of sawn timber. The distortion is highly influenced by parameters such as spiral grain angle, modulus of elasticity, shrinkage, growth stresses and sawing pattern. • In this study a finite element simulation of log sawing and timber drying was performed to study how these parameters interact to affect board distortion. A total of 81 logs with different material combinations were simulated. From each simulated log four boards with different annual ring orientation were studied. • The results showed that the elastic modulus, shrinkage coefficient and growth stresses had a large influence on the final bow and spring deformation. After sawing of the log into boards, the release of growth stresses was the main contributor to the bow and spring deformation. For boards with low modulus of elasticity, the bending distortion became larger than for the boards with high modulus of elasticity. The twist deformation was very small after sawing but increased significantly during drying of the boards. The results showed that spiral grain angle and the board location within the log were the main contributors to the twist deformation.Influence des contraintes de croissance et des propriétés du matériau sur la déformation des sciages. Analyse numérique. • La déformation des planches qui se produit au cours du sciage et du séchage conduit à des difficultés importantes pour l'utilisation des sciages. Les déformations sont très dépendantes de paramètres tels que l'angle du fil, le module d'élasticité, les retraits, les contraintes de croissance et le plan de débit. • Dans cette étude nous avons réalisé une simulation par éléments finis du sciage de billons et de leur séchage pour étudier comment ces paramètres interagissent et affectent la distorsion des planches. Nous avons simulé un total de 81 billons avec différentes combinaisons des propriétés du matériau. Pour chaque billon quatre planches sont simulées avec différentes orientations des limites de cernes. • Les résultats montrent que le module d'élasticité, les coefficients des retraits et les contraintes de croissance ont une grande influence sur la courbure finale de la face et sur la courbure de chant. Après le sciage des billons en planches, la libération des contraintes de croissance est le principal contributeur des deux déformations précédentes. Enfin, on montre que l'angle du fil et la position de la planche dans le billon sont les principales causes du gauchissement

Factors influencing community pharmacists’ knowledge about women’s issues in epilepsy

BackgroundPrevious studies have highlighted instances where pharmacists lacked knowledge regarding women’s health issues related to epilepsy.ObjectivesTo assess UAE community pharmacists’ knowledge, toward women’s issues in epilepsy.Methodsa cross-sectional research method was employed. A team of seven pharmacy students in their final year visited a randomly selected sample of community pharmacies in the UAE and face-to-face interviews were conducted with the pharmacists using a structured questionnaire. The questionnaire includes two parts; Eight questions designed to elicit data about the demographics of the study participants and 12 questions eliciting insights into the participants’ knowledge of women’s issues in epilepsy.ResultsA total of 412 community pharmacist were recruited in the study. The overall level of knowledge about women’s issues in epilepsy was good and the average knowledge score was 81% with a 95% confidence interval (CI) [79.1, 82.7%]. The results of multivariate analysis showed higher knowledge scores in chain pharmacies (OR 1.37; 95% CI 1.12–1.67), Chief pharmacists (OR 1.44; 95% CI 1.01–2.06), Pharmacists in charge (OR 3.46; 95% CI 2.7–4.45), pharmacists with 1–5 Years of experience (OR 2.87; 95% CI 1.71–4.82), pharmacists with 6–10 Years (OR 2.63; 95% CI 1.58–4.38), pharmacists with >10 years (OR 3.13; 95% CI 2.03–4.83), graduation form regional universities (OR 1.37; 95% CI 1.12–1.67), graduation form international universities (OR 1.73; 95% CI 1.36–2.20) and receiving a training on epilepsy (OR 1.36; 95% CI 1.12–1.67).ConclusionWhile the findings reveal an overall promising level of knowledge among community pharmacists regarding the issues faced by women with epilepsy, pinpointing which clinical and demographic factors have the most significant impact on this knowledge would permit the implementation of tailored educational interventions. Workshops and modules targeting the issues faced by women with epilepsy would further raise the knowledge and competence among community pharmacists in this area, ensuring better pharmaceutical care for this population